Provider Demographics
NPI:1396983532
Name:MAHMUD, JAMAL (MD)
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:
Last Name:MAHMUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2921
Mailing Address - Country:US
Mailing Address - Phone:856-449-7855
Mailing Address - Fax:215-685-7926
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2516
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA083709002084P0800X
PAMD4279662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry